Flu vaccine breakthrough

Influenza virus, A/Hong Kong/1/68

Yesterday, when commenting on Bill Gates' vaccine efforts, I wrote that a key breakthrough might be "an influenza vaccine that targets a conserved region of the virus, which would eliminate the need for costly annual vaccinations."  As if on cue...

The Guardian reports of an influenza vaccine breakthrough out of Oxford University. The new vaccine, developed by Dr Sarah Gilbert's team, targets proteins inside the flu virus that are common across all strains. The two proteins, Nucleoprotein and matrix protein 1, are more than 90% conserved across all influenza A strains and less liable to change over time.

In their initial human trial of 11 healthy vaccinated people and 11 non-vaccinated people, they exposed them to what I think is A/Wisconsin/67/2005 (H3N2). Fewer vaccinated people got the flu and vaccinated people had more T-cells and more activated T-cells. We will have to wait a bit for more details, since they have just submitted the paper for publication. Interesting that the Guardian is reporting this before a a medical journal. Given how dysfunctional the peer-review process is these days (STAR-ICU trial anyone?), I don't blame them for communicating the results in this time-efficient manner.

You can read about the initial vaccine creation and phase 1 safety trial of the Modified Vaccinia virus Ankara vector encoding nucleoprotein and matrix protein 1 in the January 1st CID.

Guardian article by Alok Jha

Berthoud et al Clin Infect Dis, January 1, 2011

Bill Gates pledges $10 billion to vaccinate children

Source: Gizmodo.com

Bill Gates spoke with Sanjay Gupta (CNN) recently and is pledging $10 billion over 10 years to vaccinate children worldwide.  Gates' plan:

"Over this decade, we believe unbelievable progress can be made, in both inventing new vaccines and making sure they get out to all the children who need them. We could cut the number of children who die every year from about 9 million to half of that, if we have success on it. We have to do three things in parallel: Eradicate the few that fit that profile -- ringworm and polio; get the coverage up for the vaccines we have; and then invent the vaccines -- and we only need about six or seven more -- and then you would have all the tools to reduce childhood death, reduce population growth, and everything -- the stability, the environment -- benefits from that."

My favorite quote (the counterfactual):  "In fact, it is so simple, people often forget what a big deal this is. The 2 million people that would have died from smallpox now don't think, 'Wow, I'm alive today because of vaccinations,' but that's the case."

It will be interesting to see if this effort can lead to 6 or 7 new vaccines.  A key one would be an influenza vaccine that targets a conserved region of the virus, which would eliminate the need for costly annual vaccinations.  I think we will also need a similar effort to identify new antibacterials before too long.

Full transcript and video of Bill Gates interview (CNN.com)

h/t gizmodo

S. aureus vaccine breakthrough?

Researchers at the University of Rochester have just announced a potential breakthrough in S. aureus (MRSA) vaccine methods.  Edward Schwarz and John Varrone presented their new findings at the Orthopaedic Research Society annual meeting in Long Beach, Calif this past week.

Their work targets the S. aureus glucosaminidase (Gmd) protein, which is thought to act as a zipper by opening the bacterial cell wall during cell division. Importantly they discovered four anti-Gmd monoclonal antibodies that prevented growth in cell culture. They also demonstrated that mice treated with anti-Gmd antibody were half as likely to develop infection. Phase I human trials are planned for 2012.

References:
URMC Press Release

RSC Article

h/t Mark Vander Weg

The History of Vaccines (new website)

The College of Physicians of Philadelphia, the oldest professional society in the United States, has just launched a new educational website on the History of Vaccines. There is so much information available, that it literally will blow your mind. I should post a picture, it's not pretty. Topics include "The Development of the Immunization Schedule," a timeline of vaccination history from the year 1000, "History of the anti-Vaccination Movements," and "Top 20 Questions about Vaccines." There are already 424 images and videos for your use and education. Wow.

The site has been planned for several years and has been in development for a year. It will officially launch on November 3, 2010, when Stanley A. Plotkin, MD, developer of the current rubella vaccine, and emeritus professor of The Wistar Institute and The University of Pennsylvania, will give the Samuel X Radbill lecture entitled "Four Centuries of Vaccinology" in Philadelphia.

Check out the preview version of the website "The History of Vaccines" and related blog. Just fantastic.

h/t Tara Smith at Aetiology

Sunday reading

A couple recent New York Times articles relevant to infection prevention are worth a read. The first reports on an Annals of Internal Medicine paper describing how cost and reimbursement serve as barriers to the uptake of the adult varicella zoster virus (VZV, shingles) vaccine. The second is a fascinating story about the last of the old-time TB sanitariums. Although directly observed therapy (DOT) outside the hospital is the current model, there are some for whom prolonged inpatient care is needed, including those with dual diagnoses or extremely-drug resistant TB for whom simple outpatient DOT regimens are not feasible.

NY Times article on VZV vaccine
Annals paper describing barriers to vaccine uptake
NT Times article on A.G. Holley TB hospital